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  In order to send you information on Interfund Capital's hedge funds, we need to ascertain that you are an "accredited investor," as defined in Regulation D under the Securities Act.

Please complete the following information, check the box(es) below indicating the basis on which you qualify as an investor, and submit the questionnaire..

All personal information fields are required.

First Name:
Last Name:
Number of Years Investing:
Email Address:
Mailing address (line 1):
Mailing address (line 2):
City:
State
Country:
Zip:
Day/Home Phone:

Qualification as an Accredited Investor. Please Check the categories applicable to you indicating the basis upon which you qualify as an accredited investor for purposes of the Securities Act and Regulation D thereunder:

INDIVIDUAL WITH NET WORTH IN EXCESS OF $1.0 MILLION. A natural person (not an entity) whose net worth, or joint net worth with his or her spouse, at the time of purchase exceeds $1,000,000.

INDIVIDUAL WITH A $200,000 INDIVIDUAL ANNUAL INCOME. A natural person (not an entity) who had an individual income of more than $200,000 in each of the preceding two calendar years, and has a reasonable expectation of reaching the same income level in the current year.

INDIVIDUAL WITH A $300,000 JOINT ANNUAL INCOME. A natural person (not an entity) who had joint income with his or her spouse in excess of $300,000 in each of the preceding two calendar years, and has a reasonable expectation of reaching the same income level in the current year.

CORPORATIONS OR PARTNERSHIPS. A corporation, partnership, or similar entity that has at least $5 million of assets and was not formed for the specific purpose of acquiring an Interest in the Partnership.

REVOCABLE TRUST. A trust that is revocable by its grantors and each of whose grantors is an accredited investor. (If this category is checked, please also check the additional category or categories under which the grantor qualifies as an accredited investor.)

IRREVOCABLE TRUST. A trust (other than an ERISA plan) that (i) is not revocable by its grantors, (ii) has at least $5 million of assets, (iii) was not formed for the specific purpose of acquiring an Interest, and (iv) is directed by a person who has such knowledge and experience in financial and business matters that such person is capable of evaluating the merits and risks of an investment in the Partnership.

IRA OR SIMILAR BENEFIT PLAN. An IRA, Keogh or similar benefit plan that covers a natural person who is an accredited investor. (If this category is checked, please also check the additional category or categories under which the natural person covered by the IRA or plan qualifies as an accredited investor.)

PARTICIPANT-DIRECTED EMPLOYEE BENEFIT PLAN ACCOUNT. A participant-directed employee benefit plan investing at the direction of, and for the account of, a participant who is an accredited investor. (If this category is checked, please also check the additional category or categories under which the participant qualifies as an accredited investor.)

OTHER ERISA PLAN. An employee benefit plan within the meaning of Title I of the ERISA Act other than a participant-directed plan with total assets of at least $5 million or for which investment decisions (including the decision to purchase an Interest) are made by a bank, registered investment adviser, savings and loan association, or insurance company.

GOVERNMENT BENEFIT PLAN. A plan established and maintained by a state, municipality, or any agency of a state or municipality, for the benefit of its employees, with total assets of at least $5 million.

NON-PROFIT ENTITY. An organization described in Section 501(c)(3) of the Internal Revenue Code, as amended, with total assets in excess of $5 million (including endowment, annuity and life income funds), as shown by the organization's most recent audited financial statements.

EXECUTIVE OFFICER OR DIRECTOR. A natural person who is an executive officer, director or general partner of the Partnership or the General Partner.

ENTITY OWNED ENTIRELY BY ACCREDITED INVESTORS. A corporation, partnership, private investment company or similar entity each of whose equity owners is a natural person who is an accredited investor. (If this category is checked, please also check the additional category or categories under which each natural person qualifies as an accredited investor.)

OTHER INSTITUTIONAL INVESTOR (check one)

A bank, as defined in Section 3(a)(2) of the Securities Act (whether acting for its own account or in a fiduciary capacity);

A savings and loan association or similar institution, as defined in Section 3(a)(5)(A) of the Securities Act (whether acting for its own account or in a fiduciary capacity;

A broker-dealer registered under the Exchange Act;

An insurance company, as defined in section 2(13) of the Securities Act;

A "business development company," as defined in Section 2(a)(48) of the ICA;

A small business investment company licensed under Section 301(c) or (d) of the Small Business Investment Act of 1958, as amended;

or A "private business development company" as defined in Section 202(a)(22) of the Investment Advisers Act of 1940, as amended.

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